Child Protective Services

Handbook Revision, June 20, 2014

This revision of the Child Protective Services Handbook was published on June 20, 2014. Summaries of new or revised items are provided below.

Medical Consent

Sections of CPS Medical Consent Policy (section 11000) have been revised to comply with HB 915, 83rd Legislative Regular Session (2013). These requirements are summarized below. CPS staff were informed of these policies with the issuance of PSA 14-005 on 9/10/2013.

Medical Consenter Attendance at Psychotropic Medication Appointments

Effective September 1, 2013, any child in DFPS conservatorship who has been prescribed a psychotropic medication must have an office visit with the prescribing physician, physician’s assistant or advanced practice nurse and the Medical Consenter no less frequently than every 90 days.

DFPS staff who are designated as the medical consenter for a child must attend any appointments where psychotropic medication may be prescribed and all medication review appointments.

When the Medical Consenter is the child’s caregiver (foster parent, relative, etc.): The medical consenter must attend all appointments where psychotropic medications are reviewed and monitored. To promote medical consenter attendance at initial and follow-up psychotropic medication appointments, staff are encouraged to designate up to four medical consenters for each child in conservatorship, especially if the child's placement requires CPS staff are designated medical consenters. If there is more than one primary or backup medical consenter, they are no longer required to be a married couple.

Human Service Technician (HST) Support

Eleven new HST positions were allocated to regions by numbers of children placed in that region in a Residential Treatment Center. These staff positions were created by the legislature specifically for implementation of HB915.

These staff will help relieve I See You workers of some duties (not the psychotropic medication appointment duties) in order to create more time for I See You workers to attend psychotropic medication appointments.

Consent to the administration of a psychotropic medication is valid only if:

• the consent is given voluntarily and without undue influence;

• the person authorized by law to consent for the foster child receives details about the child’s condition, reasons for treatment, possible risks and expected benefits of the medication, probable consequences of not consenting to the medication, and alternative medications and non-pharmacological interventions verbally or in writing.

Notify Parents of Psychotropic Medication

This policy is in compliance with Texas Family Code §266.005.

DFPS is required to notify a child's parents of the initial prescription of a psychotropic medication and any change in dosage of the psychotropic medication at the first scheduled meeting between the parents and the child's caseworker after the date the psychotropic medication is prescribed or the dosage is changed.

DFPS is not required to provide the notice to a parent who cannot be located, who has executed an affidavit of relinquishment, who had rights terminated, or who has had access to medical information otherwise restricted by the court.

Transition Plan

This policy is in compliance with Texas Family Code §264.121

The legislation adds a new requirement regarding the Transitional Living Services Program. DFPS must ensure that a youth's transition plan includes provisions to assist the youth in managing medication usage after exiting foster care, including information that educates the youth.

The transition plan was updated and information about the plan is provided in PSA 13-067.

Medical Consenter Training

This policy is in compliance with Texas Family Code §266.004.

In addition to this law’s new requirements for informed consent, Medical Consent training now includes the requirement that Medical Consenters inform the child's caseworker in writing (through email or fax) the next business day when a child is prescribed a psychotropic medication.

Judicial Review of Medical Care

This policy is in compliance with Texas Family Code §266.007(a).

The statute adds new responsibilities to the list of things the court is required to do at each permanency and placement hearing.

Items Affected

The following items are revised or added:

11000 Health Care

11100 Medical Consent

11110 Court Authorizes DFPS To Be the Child’s Medical Consenter

11111 Selecting Medical Consenter and Back Up Medical Consenter

11112 Live-In Caregiver Designated as the Medical Consenter

11113 Designating Medical Consenters for Children in Conservatorship Living in Residential Facilities